Provider Demographics
NPI:1487341368
Name:KISER, HALEY M (PHD)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:M
Last Name:KISER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8720 PIQUA LOCKINGTON RD
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-9740
Mailing Address - Country:US
Mailing Address - Phone:937-570-0068
Mailing Address - Fax:
Practice Address - Street 1:1120 POLARIS PKWY STE 204
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-4042
Practice Address - Country:US
Practice Address - Phone:614-356-8565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2024-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1902067101YM0800X
OHM.1800089106H00000X
OHF.2400455106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health